Clinical, Bacteriological, and Genetic Characterization of Bone and Joint Infections Involving Linezolid-Resistant Staphylococcus epidermidis: a Retrospective Multicenter Study in French Reference Centers

Coustillères, François; Renault, Victor; Corvec, Stéphane; Dupieux, Céline; Simões, Patrícia Martins; Lartigue, Marie Frédérique; Plouzeau-Jayle, Chloé; Tandé, Didier; Lamoureux, Claudie; Lemarié, Carole; Chenouard, Rachel; Laurent, Frédéric; Lemaignen, Adrien; Bémer, Pascale; Caubrière, Marin; Vildy, Amandine; Ansart, Séverine; Quaesaet, Luc; Stindel, Éric; Greves, Anaïs; Boutoille, David; Lecomte, Raphaël; Deschanvres, Colin; Nich, Christophe; Crenn, Vincent; d’Epenoux, L. Ruffier; Bourigault, C.; Troussier, Barbara; Plantard, Barbara; Cazenave‐Roblot, F.; Moal, G. Le; Priès, P.; Thomas, Céline; Arvieux, Cédric; Baldeyrou, M.; Common, Harold; Cattoir, Vincent; Méheut, Anne; Bernard, Louis; Lacasse, Marion; Rosset, Philippe; Nail, Louis-Romée Le; Lartigue, Marie‐Frédérique; Laplaige, Isabelle

doi:10.1128/spectrum.04190-22

Cited by 6 publications

(4 citation statements)

References 40 publications

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“…Being heterogeneous, more S. epidermidis exhibited intra-species diversity with varied AMR genes. This may pose a difficulty in eradicating S. epidermidis , especially in prosthetic joint infections [ 5 , 39 ]. The potential transmission of S. epidermidis between owners and their pets was detected in five households where the dogs and dog-owners were colonized by similar CoNS species with the same genetic lineages.…”

Section: Discussionmentioning

confidence: 99%

Genetic Diversification and Resistome of Coagulase-Negative Staphylococci from Nostrils of Healthy Dogs and Dog-Owners in La Rioja, Spain

Abdullahi,

Lozano,

González-Azcona

et al. 2024

Pathogens

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Coagulase-negative staphylococci (CoNS) species in healthy dogs and their owners could be transferred between these hosts and carry diverse antimicrobial resistance (AMR) genes of public health concern. This study determined the frequency, diversity, and AMR genes of nasal CoNS from healthy dogs and in-contact people as well as the rate of intra-household (between healthy dogs and dog-owners) transmission of CoNS. Nasal samples were collected and processed from 34 dogs and 41 humans from 27 households, and CoNS identification was done by MALDI-TOF-MS. The AMR determinants and genetic lineages were determined by PCR/sequencing. A total of 216 CoNS isolates were initially obtained and identified, and the AMR phenotypes were determined. From these, 130 non-repetitive CoNS were selected (one isolate of each species per sample or more than one if they presented different AMR phenotypes) and further characterized. The predominant species from dog carriers were S. epidermidis (26.5%), S. hominis (8.8%), and S. cohnii (8.8%), whereas in the human carriers, the predominant ones were S. epidermidis (80.4%), S. lugdunensis (9.8%), and S. hominis (9.8%). Intra-host species diversity (>one CoNS species) was detected in 37.5% of dogs and 21.6% of dog-owners. Conversely, 50% of dogs and 70.3% of dog-owners had intra-species AMR diversity (2–4 AMR-CoNS profiles). About 20% were susceptible to all antimicrobial agents tested, 31.5% displayed a multidrug resistance phenotype, and 17.4% were mecA-positive, located in SCCmec type V (24.2%), III (18.1%), IVc (12.1%), and II (6.1%). The other mec-A positive CoNS isolates (39.5%) had non-typeable SCCmec. The highest AMR rates were found against erythromycin (32.3%/mph(C), msr(A)) and mupirocin (20.8%/mupA), but the resistance rates for other antimicrobial agents were <10% each. Remarkably, one linezolid-resistant S. epidermidis-ST35 isolate was identified and mediated by four amino acid substitutions in L3 and one in L4 ribosomal proteins. Dogs and dog-owners as carriers of S. epidermidis with similar AMR patterns and genetic lineages (ST59, ST61, ST166 and ST278) were detected in four households (14.8%). Diverse CoNS carriage and moderate level of AMR were obtained from this study. The detection of CoNS carrying diverse SCCmec elements and intra-species AMR diversity highlights the roles of dog ownership in the potential transmission of antimicrobial-resistant CoNS in either direction.

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Section: Discussionmentioning

confidence: 99%

Genetic Diversification and Resistome of Coagulase-Negative Staphylococci from Nostrils of Healthy Dogs and Dog-Owners in La Rioja, Spain

Abdullahi,

Lozano,

González-Azcona

et al. 2024

Pathogens

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“…None of the linezolid-resistant (LR) S. aureus tested were susceptible to DLX (MIC 50 , 0.5 mg/L; 0% of susceptibility) [ 56 ]. By contrast, DLX shows low MIC 50 (0.06 mg/L) and MIC 90 (0.50 mg/L) against LR- S. epidermidis [ 57 ]. In comparison with vancomycin and daptomycin, DLX shows greater activity on biofilms induced by MRSA or methicillin-susceptible S. aureus (MSSA), probably because of the acidic pH within these bacterial structures [ 58 , 59 ].…”

Section: In Vitro Activitymentioning

confidence: 99%

Updated Review on Clinically-Relevant Properties of Delafloxacin

Turban¹,

Guérin

Dinh

et al. 2023

Antibiotics

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The extensive use of fluoroquinolones has been consequently accompanied by the emergence of bacterial resistance, which triggers the necessity to discover new compounds. Delafloxacin is a brand-new anionic non-zwitterionic fluoroquinolone with some structural particularities that give it attractive proprieties: high activity under acidic conditions, greater in vitro activity against Gram-positive bacteria—even those showing resistance to currently-used fluoroquinolones—and nearly equivalent affinity for both type-II topoisomerases (i.e., DNA gyrase and topoisomerase IV). During phases II and III clinical trials, delafloxacin showed non-inferiority compared to standard-of-care therapy in the treatment of acute bacterial skin and skin structure infections and community-acquired bacterial pneumonia, which resulted in its approval in 2017 by the Food and Drug Administration for indications. Thanks to its overall good tolerance, its broad-spectrum in vitro activity, and its ease of use, it could represent a promising molecule for the treatment of bacterial infections.

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“…Until 2020, the global linezolid resistance rate in S. epidermidis was assumed to be low [ 7 , 8 , 9 ]. Nevertheless, various outbreaks and cases of nosocomial transmissions showed that LRSE strains are emerging as endemic pathogens in the hospital setting [ 8 , 9 , 10 , 11 , 12 , 13 ]. Severe illness, length of stay, and exposure to linezolid are cited as risk factors in several publications [ 2 , 8 , 9 , 10 , 12 , 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

“…The spread of LRSE in the hospital setting is a concern for infection control specialists as linezolid resistance restricts therapeutic treatment options to broad-spectrum antimicrobial agents. Furthermore, Coustilleres et al illustrated in their study that LRSE bone and joint infections often require complex management as the patients tend to suffer from various comorbidities [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Molecular Characterization of Clinical Linezolid-Resistant Staphylococcus epidermidis in a Tertiary Care Hospital

Campmann,

Tönnies,

Böing

et al. 2023

Microorganisms

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Staphylococcus epidermidis (S. epidermidis) is part of the human skin flora but can also cause nosocomial infections, such as device-associated infections, especially in vulnerable patient groups. Here, we investigated clinical isolates of linezolid-resistant S. epidermidis (LRSE) collected from blood cultures at the University Hospital Münster (UHM) during the period 2020–2022. All detected isolates were subjected to whole genome sequencing (WGS) and the relatedness of the isolates was determined using core genome multilocus sequence typing (cgMLST). The 15 LRSE isolates detected were classified as multilocus sequence type (ST) 2 carrying the staphylococcal cassette chromosome mec (SCCmec) type III. All isolates showed high-level resistance for linezolid by gradient tests. However, no isolate carried the cfr gene that is often associated with linezolid resistance. Analysis of cgMLST data sets revealed a cluster of six closely related LRSE isolates, suggesting a transmission event on a hematological/oncological ward at our hospital. Among the included patients, the majority of patients affected by LRSE infections had underlying hematological malignancies. This confirms previous observations that this patient group is particularly vulnerable to LRSE infection. Our data emphasize that the surveillance of LRSE in the hospital setting is a necessary step to prevent the spread of multidrug-resistant S. epidermidis among vulnerable patient groups, such as patients with hematological malignancies, immunosuppression or patients in intensive care units.

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Clinical, Bacteriological, and Genetic Characterization of Bone and Joint Infections Involving Linezolid-Resistant Staphylococcus epidermidis: a Retrospective Multicenter Study in French Reference Centers

Abstract: The manuscript describes the emergence of clonal linezolid-resistant strains of Staphylococcus epidermidis (LR-MDRSE) isolated from patients presenting with bone and joint infections. Incidence of LR-MDRSE increased over the study period.

Cited by 6 publications

References 40 publications

Genetic Diversification and Resistome of Coagulase-Negative Staphylococci from Nostrils of Healthy Dogs and Dog-Owners in La Rioja, Spain

Genetic Diversification and Resistome of Coagulase-Negative Staphylococci from Nostrils of Healthy Dogs and Dog-Owners in La Rioja, Spain

Updated Review on Clinically-Relevant Properties of Delafloxacin

Molecular Characterization of Clinical Linezolid-Resistant Staphylococcus epidermidis in a Tertiary Care Hospital

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